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Randomized Controlled Trial Multicenter Study
Fish oil in knee osteoarthritis: a randomised clinical trial of low dose versus high dose.
- Catherine L Hill, Lynette M March, Dawn Aitken, Susan E Lester, Ruth Battersby, Kristen Hynes, Tanya Fedorova, Susanna M Proudman, Michael James, Leslie G Cleland, and Graeme Jones.
- Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, South Australia University of Adelaide, The Health Observatory, Adelaide, South Australia.
- Ann. Rheum. Dis. 2016 Jan 1; 75 (1): 23-9.
ObjectivesTo determine whether high-dose fish oil is superior to low-dose supplementation for symptomatic and structural outcomes in knee osteoarthritis (OA).MethodsA randomised, double-blind, multicentre trial enrolled 202 patients with knee OA and regular knee pain. They were randomised 1:1 to high-dose fish oil (4.5 g omega-3 fatty acids) 15 mL/day or (2) low-dose fish oil (blend of fish oil and sunola oil; ratio of 1:9, 0.45 g omega-3 fatty acids) 15 mL/day. The primary endpoints were Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain score at 3, 6, 12 and 24 months, and change in cartilage volume at 24 months. Secondary outcomes included WOMAC function, quality of life, analgesic and non-steroidal anti-inflammatory drug use and bone marrow lesion score.ResultsAlthough there was improvement in both groups, the low-dose fish oil group had greater improvement in WOMAC pain and function scores at 2 years compared with the high-dose group, whereas between-group differences at 1 year did not reach statistical significance. There was no difference between the two groups in cartilage volume loss at 2 years. For other secondary endpoints, there was no difference between the two groups at 2 years.ConclusionsIn people with symptomatic knee OA, there was no additional benefit of a high-dose fish oil compared with low-dose fish oil. The combination comparator oil appeared to have better efficacy in reducing pain at 2 years, suggesting that this requires further investigation.Trial Registration NumberAustralian New Zealand Clinical Trials Registry (ACTRN 12607000415404).Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
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